Efficacy of 24-week monotherapy with acarbose, glibenclamide, or placebo in NIDDM patients. The Essen Study.
Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: Ninety-six NIDDM patients (35-70 years of age, body mass index [BMI] < or = 35), insufficiently treated with diet alone (HbA1c 7-9%) were randomized into three groups and treated for 24 weeks with acarbose, glibenclamide, or placebo. Efficacy, based on fasting blood glucose (BG), BG 1 h after ingestion of standard breakfast (postprandial), serum insulin, postprandial insulin increase, and HbA1c; and tolerability, based on subjective symptoms and laboratory values, were investigated every 6 weeks. Efficacy evaluation was valid for 85 patients. RESULTS: The test drugs were dosed as follows: 100 mg acarbose (A) three times a day, 1 placebo tablet three times a day, 3.5 mg glibenclamide tablets dosed 1-0-0 or 1-0-1, mean dose 4.3 mg/day. Compared with the placebo, both drugs showed the same mean efficacy on fasting BG (-1.4 mM with acarbose, -1.6 mM with glibenclamide), 1-h postprandial BG (-2.2 mM with acarbose, -1.9 mM with glibenclamide), and HbA1c (-1.1% with acarbose, -0.9% with glibenclamide); but they showed a marked difference in 1-h postprandial insulin values (-80.7 pM with acarbose, 96.7 pM with glibenclamide). The mean relative insulin increase (1-h postprandial) was 1.5 in the placebo group, 1.1 in the acarbose group, and 2.5 in the glibenclamide group. No changes in body weight could be observed. No adverse events were seen under placebo. Acarbose led to mild or moderate intestinal symptoms in 38% of patients. Glibenclamide led to hypoglycemia, which could be solved by dose reduction, in 6% of patients. No dropouts occurred in any of the treatment groups. CONCLUSIONS:
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Authors | J Hoffmann, M Spengler |
Journal | Diabetes care
(Diabetes Care)
Vol. 17
Issue 6
Pg. 561-6
(Jun 1994)
ISSN: 0149-5992 [Print] United States |
PMID | 8082525
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Blood Glucose
- Cholesterol, HDL
- Dietary Carbohydrates
- Glycated Hemoglobin A
- Hypoglycemic Agents
- Insulin
- Placebos
- Triglycerides
- Trisaccharides
- Cholesterol
- Glyburide
- Acarbose
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Topics |
- Acarbose
- Adult
- Aged
- Blood Glucose
(metabolism)
- Cholesterol
(blood)
- Cholesterol, HDL
(blood)
- Diabetes Mellitus, Type 2
(blood, drug therapy, urine)
- Diet, Diabetic
- Dietary Carbohydrates
- Energy Intake
- Female
- Glyburide
(therapeutic use)
- Glycated Hemoglobin
(analysis)
- Glycosuria
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin
(blood)
- Male
- Middle Aged
- Placebos
- Triglycerides
(blood)
- Trisaccharides
(adverse effects, therapeutic use)
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